Nonconvulsive status epilepticus in peritoneal dialysis patients

This report describes nonconvulsive status epilepticus (NCSE) in four patie nts with end-stage renal disease (ESRD) on peritoneal dialysis therapy. All patients presented with acute confusion or stuporous state without clinica l motor seizures. Three patients had active systemic infections and were be ing administered antibiotics. Diagnoses were confirmed in all cases by elec troencephalogram (EEG), which showed characteristic diffuse sharp waves and spikes. The EEG appearance improved after anticonvulsant therapy. All pati ents had satisfactory control of their electrical seizure activity and made varying degrees of mental recovery. To our knowledge, this is the first re ported series of NCSE in patients with ESRD on peritoneal dialysis therapy. It shows NCSE as a differential diagnosis for acute confusion. We emphasiz e the need for nephrologists to consider NCSE as a differential diagnosis f or uremic encephalopathy. (C) 2001 by the National Kidney Foundation, Inc.